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NPI Code Detail

MEDICARE: LISA EVANS

MEDICARE: LISA EVANS
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1164W00000XLicensed Practical NurseLPN.113834.MED-IVOH

General Provider Information

NPI Number : 1942153309
Entity Type Code : Individual
Provider Name (Legal Business Name) : LISA EVANS
Provider Business Mailing Address
First Line : 1812 W 44TH ST
Second Line :
City : LORAIN
State : OH
Zip : 44053-3041
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 1530 W RIVER RD N
Second Line :
City : ELYRIA
State : OH
Zip : 44035-2791
Country : US
Telephone Number : 440-324-5555
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/17/2026
Last Update Date : 02/18/2026

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Directions to “ LISA EVANS ” Practice Location

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